Provider Demographics
NPI:1881658573
Name:GRIFFIN, JOSEPH LAIRD (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LAIRD
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 MAIN STREET SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645
Mailing Address - Country:US
Mailing Address - Phone:828-758-2309
Mailing Address - Fax:828-758-0012
Practice Address - Street 1:233 MAIN STREET SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-758-2309
Practice Address - Fax:828-758-0012
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22572207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937249Medicaid
NC8937249Medicaid
NCC88165Medicare UPIN
NC206818AMedicare ID - Type Unspecified